Dental assistants take x-rays — the Bureau of Labor Statistics lists processing x-rays among the occupation's duties — but the x-ray certification or license that comes first is decided state by state.
Some states require a radiology permit, certificate, license, or board-issued certification before you take radiographs, and some accept a pass on the Dental Assisting National Board's Radiation Health and Safety (RHS) exam toward that requirement.
Throughout, the assistant captures and processes the images; examining x-rays is on BLS's dentist duties list, so reading them and diagnosing from them is the dentist's job.
The short answer
Taking x-rays is a routine part of the job — the BLS duties list for dental assistants includes processing x-rays.
The catch is the credential: whether you need a radiology permit, certification, course, or exam before exposing dental x-rays is decided state by state, and it isn't treated as a basic, day-one duty everywhere — states typically don't license entry-level assistants, but some do require a credential for radiography.
So the honest answer isn't a flat "yes" — it's "yes, once you're qualified."
What that qualification looks like, and how quickly you can earn it, is where states differ.
Radiology rules are state-specific — verify before you operate equipment
What x-ray certification does a dental assistant need?
DANB's certification list — NELDA, CDA, COA, CPFDA, CRFDA, CDIPC, and DISIPC — has no x-ray certificate on it, and operator credentials are state-specific.
Whether an assistant needs a credential to take x-rays — and what that credential is called — is decided by each state's dental board, and the name changes at the state line.
Maine licenses dental radiographers.
Mississippi requires a Radiology Permit from its Board of Dental Examiners.
Texas requires a Dental Assistant Radiology Certificate — issued as Registered Dental Assistant (RDA) registration — to position or expose dental x-rays, Tennessee requires a registered dental assistant to hold board-issued radiology certification, and South Dakota registers dental radiographers.
| State | The x-ray credential it requires |
|---|---|
| Maine | Dental radiographer license (Board of Dental Practice) |
| Mississippi | Radiology Permit (State Board of Dental Examiners) |
| Texas | Dental Assistant Radiology Certificate (issued as RDA registration) |
| Tennessee | Board-issued radiology certification required |
| South Dakota | Dental radiographer registration (State Board of Dentistry) |
Alongside the state credentials sits one national building block some states use: DANB's Radiation Health and Safety (RHS) exam.
RHS is one of the three component exams of DANB's national Certified Dental Assistant (CDA) certification — and of its entry-level NELDA certification — but it's an exam, not a certification in its own right: when a posting or a state rule asks for "RHS," it's naming the test.
RHS can be taken separately from the full CDA — DANB lets the CDA's component exams be taken separately or together; confirm current eligibility details with DANB, which updates them periodically.
Some states build an RHS pass into their radiology requirement — Connecticut permits x-ray delegation only to assistants who have passed DANB's RHS exam or a radiation competency assessment from a CODA-accredited Connecticut program, and Massachusetts requires a radiology course plus RHS or another board-approved exam within one year of the course — while others set their own course and certification requirements instead.
For the full national and state credential map, see our guide to dental assistant certifications.
What "taking x-rays" includes — and what it doesn't
When a qualified assistant takes x-rays, the job is to position the patient and sensor, set the exposure, capture the image, and process it — all while following radiation-safety practices that protect the patient and the team.
It's skilled, hands-on work, and it's where a radiology permit earns its keep.
What the assistant does not do is read the images for disease — BLS splits the same radiographs across two duty lists: processing x-rays is on the dental assistant list, and examining x-rays is on the dentist's list.
Identifying decay, bone loss, or pathology from a radiograph is the dentist's call.
The assistant produces a diagnostic-quality image; the dentist interprets it.
How the rules vary by state
The pattern is consistent even if the details aren't: assistants take x-rays within whatever rule their state sets — a license, permit, certificate, or registration where one is required, and no board credential at all in states like West Virginia.
California, for example, requires anyone in a dentist's office who operates dental radiographic equipment to have passed a board-approved radiation safety course (or the board's radiation safety exam before 1985).
West Virginia sits at the other end of the range: its board says a dental assistant needs no permit from the dental or radiology board to take intraoral x-rays in a dental office.
Treat these as examples of the range, not a checklist — the only authority for your situation is your state's own rule, which can change.
Our dental assistant requirements by state pages quote each state's current rules, and our CDA vs. RDA guide untangles how state titles and national certification interact.
How do you get x-ray certified as a dental assistant?
Start with your state dental board, because it decides both whether you need a credential and which course or exam earns it.
From there, the path a state sets has up to three steps.
Take the course your state accepts — in California, that's a board-approved radiation safety course.
Sit the exam your state recognizes — a DANB RHS pass is accepted in some states, while others set their own course and certification requirements.
Then apply for the state credential where one exists: Ohio's dental x-ray machine operator certificate, for instance, goes to applicants holding DANB, Ohio Commission on Dental Assistant Certification, or AMT certification — or who completed an approved program of at least seven hours of x-ray instruction — with a $32 application fee.
Radiology is a natural early step on the credential ladder from trainee to a credentialed hire.
Once you hold it, keep the certificate where your state says it belongs — California requires the original or a copy of the current radiation safety certificate to be publicly displayed at the treatment facility.
For what the RHS exam actually covers, see our breakdown of the DANB CDA exam (RHS, ICE, and GC).
This article is general career information, not legal advice. Radiography certification and scope rules vary by state and change over time — confirm current requirements with your state dental board.